Organization
WHITE EARTH BAND OF CHIPPEWA
Active
Other names
White Earth Mental Health Program
Organization subpart
No
Provider details
NPI number
Authorized official
AMY NATHE (CLINICAL TREATMENT DIRECTOR)
(218) 983-3286
Entity
Organization
Contact information
Practice address
26246 CRANE RD, WHITE EARTH, MN 56591-9998
(218) 983-3286
(218) 983-4236
Mailing address
PO BOX 300, WHITE EARTH, MN 56591-0300
(218) 983-3286
(218) 983-4236
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
961994100
MN
251S00000X
Community/Behavioral Health Agency
Primary
961994100
MN
261QM0850X
Adult Mental Health Clinic/Center
—
MN
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
961994100
—
MN
Enumeration date
10/24/2006
Last updated
11/16/2015
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